A surgical navigation system to assist in chronic total occlusion intervention

The conventional intervention for chronic total occlusion (CTO) of the coronary artery has crucial challenges for its successful outcome; surgeons should understand the vascular anatomy and the instrument location, solely depending on two-dimensional (2D) X-ray images. Excessive doses of both X-ray radiation and the contrast agent from continuous fluoroscopy are also critical limitations in clinical practice. To overcome the problem, we propose a surgical navigation system to guide the CTO intervention and delineate technical details to implement the system. The proposed system provides overlay of a 3D computed tomographic angiography (CTA) model onto X-ray images, virtual reality, and multi-planar reconstruction images. We expect the proposed navigation system to potentiate the procedure with reduced operating time, while alleviating the limitations regarding immoderate doses of X-ray radiation and contrast agent by reduced use of fluoroscopy.